Substance Abuse and Intimate Relationships

Jennifer L. Baker, Psy.D. Anne B. Summers, Ph.D. Debbi Steinmann, M.A.

Training Instructor / MentorsMelissa A. Gibson, M.S.

Kim Rozell, M.A.

Graduate AssistantsBrent Anderson, M.S. Matthew Biller, M.A. Cate Brandon, M.A Dawn Clinard, M.A.Jessie Clinton, M.S.

Tabitha Carlson, M.S.Anup Jonathan

Tony Larson, B.A. Nicole Mannis, M.A.

Robert Mindrup, M.S.S.W.Colleen Quinn, Ph.D. Amber Schafer, M.A.

Amanda Schroeder, B.S.

The Training for the Healthy Marriage

and Family Formation

curriculum was created through the cooperative

efforts of:

Recent Statistics on Substance Abuse

• Substance abusers dramatically impact the lives of the people around them.

• One out of ten individuals currently struggle with substance abuse or dependence.

• Two out of ten have been alcohol dependent at some time during their lives.

How many are

affected?

• Substance abuse negatively impacts not only the drinker, but also his/her partner and other family members.

• Approximately one child in every four (28.6%), in the U.S., is exposed to alcohol abuse or dependence in the family.

• A third of Americans report family problems due to alcohol abuse.

The Family

• Often the family system has unintentionally evolved to support the addiction.

• Each family member plays a role that serves a specific purpose.

• Each family member must perform his or her role to keep the family functioning.

Family Roles

• The dependent is the substance abuser.• The enabler is the one closest to the

dependent.• The enabler’s behavior, allows the

dependent person to continue drinking.• Rescuing and caretaking behaviors• Taking care of household chores, etc.• Inner feelings – powerlessness, self-pity,

fear.

Family Roles

• Family Hero: often the oldest child, “high achiever”

• Scapegoat: often the second born child, “troublemaker”

• Lost Child: Usually a middle child, “loner”

• Mascot: often the youngest child, “class clown”

Summary of Family Roles

• Most people can identify with parts or combinations of these roles.

• However, in an alcoholic or dysfunctional family, these roles are usually fixed and inflexible.

• Other types of family dysfunction, addictions, or mental illness may produce similar roles in the family.

Impact on the Family

• Increased level of stress.

• Higher incidence of domestic violence.

• Lack of trust, often due to broken promises to cut back or quit using the substance.

• Anger and resentment may begin to build.

Impact on the Family

• When parents become preoccupied with drugs, or any other activity which dominates and monopolizes their time and energy, children suffer.

• Children often lack the love, support, and care that they so desperately need.

Impact on the Family

• Chaotic and inconsistent home environment.– Lack of routines.– Kids never know what to

expect.

• Inadequate supervision and monitoring.

• May be exposed to violence.

• Increased risk of teenage substance use.

Impact on Couples

Often leads to unhappiness within the

relationship.

Arguing andFighting

Increased conflict

More substance abuse

Impact on

Couples

Assessment of Relational Factors

• Examine the extent or seriousness of substance use by each partner.– Tell-tale signs

• Strengths and weaknesses of the couple relationship. – Empowering the couple

Couple Relationship Assessment: The 7 C’s

• Character Features

• Cultural Factors

• Contract

• Commitment

• Caring

• Communication

• Conflict Resolution

How Do I Know If My Partner or I Have a

Problem?

Assessment of Substance Abuse

• Informal assessment– Types of substances– Quantities– Frequencies of use

• Formal assessment– CAGE– UNCOPE

CAGE

HAVE YOU EVER…• Thought you should Cut down

on drinking? • Become Annoyed when people

criticize your drinking? • Felt scared, bad, or Guilty about

your drinking? • Taken an Eye-opener drink to

feel better in the morning?

UNCOPE

• Consists of six questions.

• Most appropriate for identifying risk for abuse or dependence when neither is identified as the presenting problem.

• Easy to administer and score.

UNCOPE U- “Have you continued to use alcohol or drugs longer than you intended or have you spent more time drinking or using than you intended?”

N- “Have you ever neglected some of your usual responsibilities because of alcohol or drug use?”

C- “Have you ever wanted to cut down on using alcohol or drugs

but couldn’t?”

O- “Has your family, a friend, or anyone else ever told you they objected to your alcohol or drug use?”

P- “Have you ever found yourself preoccupied with wanting to use alcohol or drugs?

E- “Have you ever used alcohol or drugs to relieve emotional discomfort, such as sadness, anger, or boredom?”

Goals for Effective Treatment

• Eliminate abusive drinking and drug use, and gain partner support to reinforce sobriety.

• Alter partner interactions to promote a family environment supporting abstinence.

There is hope . . .

• Chemical dependency is treatable.

• Families can change patterns of interaction.

• The process is difficult, but help is available.

• Treatment for the substance abuser and the family is critical.

Websites

Partnership for a Drug-Free America:http://www.drugfree.org/

American Council for Drug Education:http://www.acde.org/

National Institute on Drug Abuse:http://www.nida.nih.gov/

Phoenix House:http://www.phoenixhouse.org

Substance Abuse and Mental Health Services Administration:http://www.samhsa.gov

Questions